Virtual Library
Start Your Search
Po-Lan Su
Author of
-
+
P21 - Locoregional and Oligometastatic Disease - Treatment of Locally Advanced NSCLC (ID 131)
- Event: WCLC 2020
- Type: Posters
- Track: Locoregional and Oligometastatic Disease
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
-
+
P21.12 - An Observational Study of Treatment Outcome in Stage III Lung Cancer Patients in Taiwan: KINDLE study (ID 3265)
00:00 - 00:00 | Presenting Author(s): Po-Lan Su
- Abstract
Introduction
Stage III non-small cell lung cancer (NSCLC) constitutes about one-third of NSCLC patients and is very heterogeneous with varying prognosis. Because of its high heterogeneity, a general schematic management approach is not appropriate. The treatment approach is usually the combination of local therapy (surgery or radiotherapy) with systemic chemotherapy. The KINDLE study is a multi-center, multi-country, longitudinal cohort study to assess the treatment outcome of patients with stage III non-small cell lung cancer (NSCLC). In this report, we present the outcome of Taiwanese population in the KINDLE study.
Methods
From 01 January 2013 to 31 December 2017, patients diagnosed with stage III NSCLC were recruited, of whom patients with follow-up period less than 9 months were excluded. The baseline characteristics were recorded, including age, gender, social behavior (smoking and asbestos exposure), stage, histology subtype, mutation subtype, performance status, and treatment modalities. All patients were followed until death or 31 December 2018. The event-free survival (EFS) and overall survival (OS) were estimated by the Kaplan–Meier method and compared between patients at different disease characteristics using the log-rank test.
Results
There are total 3151 patients across 19 countries, including 200 patients in Taiwan subgroup. The EFS and OS of total population were 10.3 (interquartile range, 8.8 to 11.8) months and 24.8 (interquartile range, 21.3 to 27.4) months, respectively. The patients with stage IIIA and stage IIIB NSCLC have similar median EFS (11.4 vs. 9.2 months, respectively; P = 0.143) and median OS (29.5 vs. 24.1 months, respectively; P = 0.085). In contrast, patients with resectable disease have better median EFS (13.4 vs. 8.6 months, respectively; P = 0.014) and OS (33.9 vs. 20.5 months, respectively; P < 0.001) than patients with unresectable disease. Moreover, in either resectable subgroup or unresectable subgroup, both the EFS and OS were also similar between patients with stage IIIA and IIIB NSCLC. These data indicate that the resectability is a more important prognostic factor than stage among patients with stage III NSCLC.
Among 55 patients with resectable disease, 53 underwent the surgery and 2 received chemo-radiotherapy (CRT)-based therapy. The median EFS was significantly longer in patients undergoing the surgery compared to those receiving CRT-based therapy (14.7 vs. 7.5 months, respectively; P = 0.028); however, the median OS was not significantly different between the two cohorts (34.9 vs. 25.5 months, respectively; P = 0.339). Among 116 patients with unresectable disease, 38 received curative-intent CRT-based therapy and 78 received palliative therapy. Both median EFS and OS were comparable between patients receiving different treatment approaches.
Conclusion
In the Taiwanese subgroup of KINDLE study, the resectability is the major prognostic factor in patients with stage III NSCLC. Although the surgery seemed to result in better EFS in patients with resectable disease, the OS was similar among patients receiving different treatment approaches. Further subgroup analysis is warranted to explore the predictive value of other baseline characteristics (e.g., TNM stage, EGFR status, subsequent therapy).
-
+
P76 - Targeted Therapy - Clinically Focused - EGFR (ID 253)
- Event: WCLC 2020
- Type: Posters
- Track: Targeted Therapy - Clinically Focused
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
-
+
P76.80 - The Role of Surgical Resection of Advanced Non-Small Cell Lung Cancer after a Response to EGFR-TKI (ID 3493)
00:00 - 00:00 | Presenting Author(s): Po-Lan Su
- Abstract
Introduction
The epidermal growth factor receptor-tyrosine kinase inhibitots (EGFR-TKIs) have become the mainstay treatment for advanced EGFR mutation-positive non-small cell lung cancer (NSCLC). Although it provides significant improvement in objective response rate and progression-free survival, disease progression in inevitable and subsequent therapy remains challenge. Recently, there are growing studies focused on the combination treatment strategy to improve the treatment outcome. In current study, we will evaluate the role of residual tumor resection during the use of EGFR-TKI in patients with advanced EGFR-mutant NSCLC.
Methods
Patients with EGFR mutation-positive advanced NSCLC who visited a tertiary referral center from 01 January 2014 to 31 December 2019 were analyzed retrospectively. They received EGFR-TKI until disease progression, death, or intolerable adverse events. The progression-free survival (EFS) and overall survival (OS) were estimated by the Kaplan–Meier method and compared using the log-rank test.
Results
Total 385 NSCLC patients were enrolled, inclucing 43 patients receiving residual tumor resection during the use of EGFR-TKI. Patients receiving surgery were female predominance, better performance status and less brain metastasis. With Cox proportional hazard regression analysis to exclude potential confounders, patients receiving surgery had a significantly better PFS [46.2 vs. 11.5 months, hazard ratio 0.33, p<0.001] and OS [not reached vs. 28.5 months, hazard ratio 0.20, p=0.002] than patients without surgical resection. In subgroup analysis, patients with contralateral lung metastasis have more benefit from residual tumor resection.
Conclusion
In present study, the salvage surgery for residual lesions provide better PFS and OS, it also become an independent good prognostic factor. Further prospective cohort study is warranted to validate the role of surgery in patients with advanced NSCLC harboring EGFR mutations.
